Mechanics of the Left Ventricle in Children Born Prematurely

Abstract

An increase in the birth rate of premature and low birth weight children at the current level of medical development requires the development of fundamental ideas about the physiology of the cardiovascular system in a history of preterm birth from the point of view of pre- and postnatal ontogenesis. Practicing neonatologists, pediatricians, therapists, cardiologists, reproductologists, etc. it is necessary to improve the traditional ideas about the mechanisms of damage to the cardiovascular system in this category of patients. Because it is established that this clinical subgroup is characterized by increased risks of early onset of pathology of the heart and blood vessels, as well as a high mortality rate in adulthood. Pathological changes of the cardiovascular system in conditions of prematurity can occur at various levels of integration of the body (molecular, subcellular, cellular, organ, functional systems, organismal). The use of modern non-invasive technology “spot trace” makes it possible to study the features of segmental deformation and the variety of forms of LV torsion mechanics during postnatal growth and development in prematurely born children. Optimization of research and diagnostic processes in the field of mechanics of the infant heart in the prenatal and postnatal periods from the point of view of progressive data on anatomy, histology, clinical biochemistry allows us to study the nature of various contractile-rotational models, as well as reasonably assume the contribution of the fibrous skeleton of the infant heart to the formation of “childhood types” of left ventricular twisting. The search and development of informative criteria for the early diagnosis of latent subclinical heart dysfunction in childhood, taking into account the possibilities of non-invasive ultrasound technology “spot trace” (analysis of types of rotational movement, determination of areas of reduced longitudinal deformation of the left ventricle), based on the current provisions of evidence-based medicine, have become quite possible in modern conditions and are demonstrated by the authors in this review. The information offered to the readers will allow to expand the understanding of the physiology and pathophysiology of the infant heart with a history of premature birth, bearing in mind the fact that prematurity is considered a chronic condition.